Article Text

Download PDFPDF

11 Convergence insufficiency: are we making a difference in patients’ lives or is it a waste of time!
  1. JLZ Jong,
  2. Z Saleem,
  3. J Simmons,
  4. M Rhodes,
  5. JL Choi
  1. Sheffield Teaching Hospital NHS Trust, UK


Convergence insufficiency (CI) is a common condition that can impair visual performance and comfort during close visual work. This prospective study evaluated the effectiveness of interventions on clinical outcomes and quality-of-life using the adult strabismus quality-of-life questionnaire (AS20) in patients with CI.

Data was extracted from a database collected at first consultation from 2015 to 2022. Demographics, interventions and outcomes of 84 patients with CI (mean age 47.0±24.9 years) were analysed.

Orthoptic exercises were prescribed to 56% of patients, 32% received prisms, 15% received no treatment, with 3 discharged on the same day. At latest follow-up review, 22.6% were recommended to continue exercises, 28.6% had prisms, 1 underwent bimedial resection and 2 had botox. The median follow-up was 5.5(5.0-55)months, 88.1% were discharged with 29.8% following failure to attend and 9.5% deceased. Near-point of convergence (NPC) improved from a median of 15(6-50)cm to 10(6-30)cm. The median AS20 score at presentation were 100(30-100) and 47.5(0-100), and post-intervention were 100(80-100) and 77.5(12.5-97.5) for psychosocial and functional components, respectively.

At the latest follow-up, the attendance failure rate was higher for exercises (36%) than for prisms (15%). Improvement was noted in NPC (33%) and mean AS20 scores was 9% higher psychosocially and 32.8% functionally, highlighting the benefits of intervention on patients’ quality-of-life.

This cohort provides valuable insights into the clinical management of CI, as evidenced by improvements in NPC and AS20 scores. However, the study also found that long-term compliance with treatment is intrinsically challenging, emphasising the importance of disease education.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.